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Rezilijentnost. pdf
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The Cornell Mental Health Model
Cornell’s Resilience Model
Mental Health Programmers Work Team
Catherine Thrasher-Carroll Jan Talbot
Kirsten Post Eynav Shura Gat Casey Carr
KiranJit Longaker Sarah Jones
Amanda Carreiro Kristyn Bochniak
Janis Whitlock
A framework for building
resilience on college campuses
The Mental Health Programmers
Workgroup
Cornell University
When we talk about mental health…
The term “mental health” is fluid and generally refers to a range of
psychological and emotional states. For our purposes, mental health refers to a positive state of psychological and emotional well-being and the conditions that foster it
Mental illness: any disorder of the mind; the psychological state of someone who has emotional or behavioral problems serious enough to require psychological/psychiatric intervention
Thriving: Flourishing, living up to one’s potential (e.g. academic, personal, social) and experiencing a sense of purpose, life satisfaction and wellbeing
Mental Illness
Thriving
Psychological distress
6% show signs of high psychological distress
35% show some distress
59% show no distress
Of all students:
20% Thriving
Whitlock, et. al., 2011 and in prep; Keyes, 2007
The mental health landscape: What
the data say
The mental health landscape
Rates of mental health challenges among
everyone, particularly youth, are high and
may be increasing (Twenge, 2010; Kessler et. al., 2004;
Guthmnan et., 2010; Gallagher et. al., 2003).
Age of onset for most mental disorders is
18-24 but symptoms often begin earlier
(most common are depression and
anxiety)
Four in ten students say that they have
been unable to function in the past 12
months do to stress, depression, and/or
anxiety (NCHA, 2010; Blanco, 2008).
Accumulation of NSSI, suicide, and psychological
distress (GPD) over a 2 year period
71.3
18.2
6.9 3.6
Changes in GPD
No GPD
History of GPDbut none after
No T1 GPD,added whilehereT1 GPD andadded more
68.3
19.3
7.5 4.9
Changes in GPD <20 yrs at T1
No GPD
History of GPDbut none after
No T1 GPD,added whilehereT1 GPD andadded more
31.7%
In sum: 10.5% students are adding some form of PD in 2 years; among those <20 at T1, the equivalent is 12.4%.
28.7%
Okay, but is there anything we can
do to prevent or ameliorate
psychological distress?
Progress from no GPD to high GPD in a
2 year period
Therapy stigma
Presence of meaning in life
History of physical abuse
Confidant categories
Pessimistic cognitive style
History of MH treatment
Endorsement of physical aggression
Acceptance of emotion
No one Peers only Peers and adult professionals Peers, professionals, and informal adults Parents
What predicts who is at risk for later psychological distress (as
measure by NSSI, suicidality, and global psychological distress)?
SES Number of
traumas reported
Life satisfaction
Model identified would correctly predict 80 of every 100 people at risk for conversion
Take away messages
• Many students at risk for later psychological distress entered with potentially mutable vulnerabilities (e.g. social connectedness, emotion acceptance and regulation, cognitive style, sense of life meaning etc..)
• Academic stress does not cause distress but exacerbates distress tendencies among those with existing vulnerabilities
• Cognitive style (pessimism / optimism) is a particularly powerful predictor of distress and thriving (and is mutable)
• Parents exert a powerful influence on mental health and wellbeing – even from afar
So, what do we do?
A Framework for building resilience
What is resilience?
Human resilience is:
An individual’s ability to positively cope with stress and adversity; “bouncing back” to a previous state of normal functioning, or using
the experience of adversity to enhance flexibility and overall functioning
And stems from:
The interaction of a person with their environment and the resulting processes that either promote well-being or protect them against the
overwhelming influence of risk factors
These processes can be helped along by experiences in families, schools, and other communities that help individuals learn how to
productively confront adversity
What are the dimensions of resilience?
Resilience is multi-dimensional (Wong, 2012):
Cognitive: How events are interpreted (cognitive style, appraisal, attribution) And how daily stressors and life circumstances are negotiated (coping)
Behavioral: Habits of persistence and endurance in face of obstacles and failures (behavioral practice and reinforcement)
Motivational: Clear sense of life purpose and commitment (will to live)
Existential/spiritual: Sense of larger purpose and meaning of human life (meaning and life purpose)
Relational: Sense of social connectedness, engagement, and altruism
Emotional: Ability to tolerate negative emotions and rejection and to maintain emotional confidence and hopefulness (emotion regulation, emotional intelligence)
Opportunities for
Connectedness to Others
Opportunities for Service
Opportunities for Efficacy &
Mastery
Opportunities for Self
Awareness
Resilience
Pathways for building student resilience
Meaning
Attention / focus
Resilience Self awareness & care
Social engagement
Opportunities for Service
Opportunities for
Connectedness to Others
Opportunities for Self
Awareness
Opportunities for Efficacy &
Mastery
Meaning
Attention / presence
Resilience Self awareness
& care
Social engagement
Service
Efficacy & Mastery
Self Awareness
Connectedness to Others
Generosity Integrity
Authenticity Humility
Meaning
Attention / presence
Resilience
Social engagement
Service
Efficacy & Mastery
Self Awareness
Connectedness to Others
Self awareness & care
Generosity Integrity
Authenticity Humility
Self-regulation Persistence
Adversity tolerance Cognitive (re)framing
Healthy physical habits
Meaning
Attention / presence
Resilience Self awareness
& care
Focus Curiosity Flexibility
Learning enjoyment
Social engagement
Service
Connectedness to Others
Efficacy & Mastery
Self Awareness
Generosity Integrity
Authenticity Humility
Self-regulation Persistence
Adversity tolerance Cognitive (re)framing
Healthy physical habits
Meaning
Attention / presence
Resilience
Self awareness & care
Focus Curiosity Flexibility
Learning enjoyment
Generosity Integrity
Authenticity Humility
Social engagement
Individual
Service
Connectedness to Others
Efficacy & Mastery
Self Awareness
Purpose Acceptance Gratitude
Hope Optimism
Self-regulation Persistence
Adversity tolerance Cognitive (re)framing
Healthy physical habits
How do we enhance/expand our efforts? • Assess how many programs, policies, and practices we already have in
each of the four action areas (service, connectedness, efficacy and mastery, self-awareness)
• Assess alignment with framework within existing programs in each domain (e.g. in stated intention, in messages about resilience and growth, and in assessments of individual experience and impact)
• Create new strategies, programs, and/or approaches to better incorporate underrepresented action areas (e.g. self-awareness and care)
• Focus on building universal and targeted outreach to particular groups (including early assessment of resilience and vulnerability profiles)
• Group specific messaging and programming
• Adapt framework to systems to identify opportunities for building resilience within groups, programs, and organizations (e.g. staff/faculty, departments, units etc..)
Questions for you
• What questions, comments, thoughts come up for you?
• What are the barriers and opportunities in your work environment for building resilience?
• What else do you need in order support the building of resilience?